﻿456 The Philippine Journal of Science i9i4 



The causes of death in entamoebic dysentery cases are summed 

 up by Strong ^ as follows : 



Death may occur in amoebic dysentery from the gravity of the intestinal 

 lesions; from exhaustion in protracted cases; from severe complications, 

 particularly such as peritonitis due to the perforation of an ulcer in the 

 large intestine or appendix or an abscess of the liver or lung; from a 

 terminal infection sometimes entering through the ulcerations in the large 

 bowel; from intercurrent disease, and from severe intestinal hemorrhage. 



All of these conditions, except the haemorrhage, have been 

 encountered in our series. 



The liver abscesses here referred to are entamcebic abscesses 

 secondary to entamoebic colitis, and do not include ordinary 

 pyaemic abscesses or those secondary to suppurative cholangitis ; 

 a number of these cases have been encountered in the present 

 series of 1,000 autopsies. 



Liver abscesses occurred in 9 (29 per cent) of our cases of 

 entamoebic colitis. This represents, it must be remembered, 

 the incidence in fatal cases of entamoebic colitis, and is no in- 

 dication of its frequence clinically. Three of these cases were 

 in Americans and 6 in Filipinos, all being males. Five of the 

 cases of liver abscess had operative drainage of the abscesses. 

 In all of the cases of liver abscess entamoebic colitis was present, 

 but there has been established no relation between the severity of 

 the intestinal lesions and the occurrence of the liver abscesses. 

 It is noteworthy that in several cases of liver abscess with ex- 

 tensive ulcerative colitis the patients denied any history of dysen- 

 teric symptoms. In 4 of the cases there was a single abscess, 

 while in the other 5 cases there were multiple abscesses. The 

 right lobe was the most frequent site of the abscess, but in some 

 cases the left lobe also was involved and in 1 case the Spigelian 

 lobe was entirely destroyed. In two cases the abscess had per- 

 forated the diaphragm, but in both the destructive process was 

 confined to the diaphragmatic surface of the lung by the presence 

 of fibrinous adhesions. Four other cases presented a right-sided 

 fibrinous pleurisy over the diaphragmatic surface and in some 

 cases fibrous adhesions were also present. One of the cases with 

 liver abscess died as the result of an acute peritonitis from an 

 entamoebic ulcer of the vermiform appendix, and in 1 case the 

 gall bladder was filled with pus similar to that found in the 

 liver abscess. 



The 5 cases referred to in the table as having acute peritonitis 

 do not include the cases of liver abscess. In 2 of the cases there 

 was actual perforation of the intestine at the site of ulceration, 



"Pub. P. I. Bur. Gov. Labs. (1905), 5, No. 32, 5. 



